The
purpose of this grant program is to expand access to, coordinate,
restrain the cost of, and improve the quality of essential health
care services, including preventive and emergency services, through
the development of integrated health care delivery systems or networks
in rural areas and regions. Specifically the purpose of the Rural
Telemedicine Grant Program is to demonstrate how Telemedicine can
be used as a tool in developing integrated systems of health care,
improving access to health services for rural citizens and reducing
the isolation of rural health care practitioners. The purpose is
also to collect information for a systematic evaluation on the feasibility,
costs, appropriateness and acceptability of rural Telemedicine.
TYPES
OF ASSISTANCE:
Project Grants. Place Cursor Here for Definition
USES
AND USE RESTRICTIONS:
Funds
may be used to demonstrate the use of Telemedicine in facilitating
the development of rural health care networks and for improving
access to health care services for rural citizens; provide a baseline
of information for a systematic evaluation of Telemedicine systems
serving rural areas; purchase or lease and install equipment; and
to operate the Telemedicine system and evaluate the Telemedicine
system. Not more than 40 percent of grant funds may be expended
for equipment. Not more than 20 percent of grant funds may be expended
for indirect costs. Grant funds may not be used for purchasing and
installing telecommunications transmission equipment (e.g., microwave
towers, satellite dishes, amplifiers, digital switching equipment
or laying cable or telephone lines). Constructions costs are allowable
only for minor renovations related to the installation of equipment.
ELIGIBILITY
REQUIREMENTS:
Applicant
Eligibility: An entity that is a health care
provider and a member of an existing or proposed Telemedicine network,
or an entity that is a consortium of health care providers that
are members of an existing or proposed Telemedicine network shall
be eligible for a grant under this section. An eligible network
may include for-profit entities so long as the network grantee is
a nonprofit entity.
Beneficiary
Eligibility: Rural health care providers,
patients, and rural communities will benefit from this grant program.
Credentials/Documentation:
The basis for determining the allowance and allocability of costs
charged to Public Health Service (PHS) grants is set forth in
45 CFR, Part 74, Subpart Q. The four separate sets of cost principles
are: (1) OMB Circular No. A-87 for State and local governments,
(2) OMB Circular No. A-21 for educational institutions, (3) 45
CFR, Part 74, Appendix E for hospitals, and (4) OMB Circular No.
A-122 for nonprofit organizations.
Pre-application
Coordination: Preapplication coordination is
not required. This program is eligible for coverage under E.O. 12372,
"Intergovernmental Review of Federal Programs." An applicant should
consult the office or official designated as the single point of
contact in his or her State for more information on the process
the State requires to be followed in applying for assistance, if
the State has selected the program for review. Applicants are required
to notify their State Office of Rural Health (or other appropriate
State entity) of their intent to apply for this grant program and
to consult with such agency regarding the content of the application.
Application
Procedure: The standard application forms
(Form PHS- 5161-1, revised 5/96), as furnished by the PHS and
required by 45 CFR, Part 92, must be used for this program. This
program is subject to the provisions of 45 CFR, Part 92 for State
and local governments and OMB Circular No. A-110 for nonprofit
organizations and hospitals. Application kits can be obtained
by writing HRSA Grants Application Center, 40 West Gude Drive,
Suite 100, Rockville, MD 20850, or by calling toll-free: 1-888-300-4772.
Award
Procedure: The review of applications is carried
out by Federal and nonfederal experts in Telemedicine and rural
health care services development, coordination, and delivery.
Applications are evaluated for merit and are scored according
to the review criteria described in the HRSA Preview. Final decisions
are made by the Director, Office for the Advancement of Telehealth.
Deadlines:
Contact Headquarters Office listed below for deadline dates.
Range
of Approval/Disapproval Time: From 4 to 5
months.
Appeals:
None.
Renewals:
Renewals have not been determined.
ASSISTANCE
CONSIDERATIONS:
Formula
and Matching Requirements: There are no statutory
formula or matching requirements for this program.
Length
and Time Phasing of Assistance: Awards are
made annually with up to a 3-year project period. Payments are
made through an electronic transfer system or cash demand system.
POST
ASSISTANCE REQUIREMENTS:
Reports:
Annual progress and financial status reports are required 90 days
from the end of the budget period and the final performance report
and final financial status report are due 90 days from the end of
the project period. Progress reports are to be submitted every 6
months.
Audits:
In accordance with the provisions of OMB Circular No. A- 133 (Revised,
June 24, 1997), "Audits of States, Local Governments, and Nonprofit
Organizations," nonfederal entities that expend financial assistance
of $300,000 or more in Federal awards will have a single or a
program-specific audit conducted for that year. Nonfederal entities
that expend less than $300,000 a year in Federal awards are exempt
from Federal audit requirements for that year, except as noted
in Circular No. A-133. In addition, grants are subject to inspection
and audits by DHHS and other Federal officials.
Records:
Grantees are required to maintain grant accounting records for
3 years after the end of the budget period. If any litigation,
audit, or other action involving the records has been started
before the expiration of the 3-year period, the records shall
be retained until completion of the action and resolution of all
issues which arise from it, or until the regular 3-year period
expires, whichever is later.
FINANCIAL
INFORMATION:
Account
Identification: 75-0350-0-1-550.
Obligations:
(Grants) FY 01 $5,689,000; FY 02 est $5,600,000; and FY 03 est
$5,000,000.
Range
and Average of Financial Assistance:
The maximum allowable amount is $325,000 for existing telemedicine
networks and $375,000 for new networks. The average award in fiscal
year 2001 was $298,947.
In fiscal year 2001, 19 non-competing continuation awards were funded.
The same number is estimated for fiscal year 2002. It is estimated
that 25 to 30 awards will be made in fiscal year 2003.
REGULATIONS,
GUIDELINES, AND LITERATURE:
Program guidelines may be obtained by contacting the Headquarters
Office for PHS Grants Policy Statement, DHHS Publication No. (OASH)
94-50,000, (Rev.) April 1, 1994.
INFORMATION
CONTACTS:
Regional
or Local Office: Not applicable.
Headquarters
Office: Amy Barkin, Co-Director of Rural Telemedicine
Grants, Office for the Advancement of Telehealth, 5600 Fishers
Lane, Room 11A-16, Rockville, MD 20857. Telephone: (301)443- 1293,
Grants Management contact: Ms. Janice Gordon, , Grants Management
Office, HIV/AIDS Bureau, Health Resources and Services Administration,
5600 Fishers Lane, Rockville, MD 20857. Telephone: (301) 443-2385.
Use the same numbers for FTS.
Web
Site Address: http://www.telehealth.hrsa.gov
EXAMPLES
OF FUNDED PROJECTS:
Good Samaritan Hospital, Mid-Nebraska Telemedicine Network, Kearney
NE: The network's goal is to provide improved access to care for
rural underserved populations in central Nebraska and north-central
Kansas. The network includes 12 sites, of which 10 are in Health
Professional Shortage Areas (HPSAs). Members of the network include
a tertiary care center, rural hospitals, psychiatric hospital, rural
health clinic, and long term care facility. Services are provided
using videoconferencing over T1 and ISDN lines. The network provides
consultations in a range of specialties, including mental health,
oncology, diabetes care and management, dermatology, cardiology,
occupational therapy, speech therapy, and others. The network is
also used for continuing medical education, medical resident education
and training, monthly EMT training, administrative meetings, and
support groups. The network will soon begin implementing telehome
care using POTS based systems, and conducting a special project
focused on children with special health care needs.
CRITERIA
FOR SELECTING PROPOSALS:
Grant applications will be evaluated on the following four criteria.
1) Documented need for the project and the likely demand for the
proposed services; measurable project objectives; likelihood that
the methodology or plan of activities will lead to attaining the
project objectives, 2) extent to which project objectives and activities
are consistent with the objectives of the grant program, 3) level
of local involvement in planning and implementing; level of commitment
as evidenced by cost participation of applicant, other network members
and/or other organizations; long-term plans for sustainability,
4) reasonableness of the budget to proposed activities and anticipated
outcomes/results.
